摘要
目的探讨硬膜外阻滞分娩镇痛对妊高征患者的血压及其血浆NO含量的影响。方法选择中、重度妊高征29例随机分为硬膜外阻滞分娩镇痛组14例和对照组15例,镇痛组宫颈扩展到3～4cm时开始实施镇痛。采用硝酸还原酶法测定无宫缩、宫口3～4cm(阻滞前)、宫口开全、产后2h血浆NO含量。结果宫口3～4cm(镇痛前)平均动脉压较无宫缩时明显增高(P<0.01),对照组宫口开全时和产后2h平均动脉压较无宫缩时明显升高(P<0.05),而镇痛组宫口开全时和产后2h平均动脉压较无宫缩时明显降低(P<0.01),也显著低于对照组(P<0.01);宫口3～4cm(镇痛前)血浆NO含量显著低于无宫缩时(P<0.01),对照组宫口开全时和产后2h血浆NO含量较无宫缩时明显低(P<0.01);镇痛组宫口开全时血浆NO含量较无宫缩和镇痛前明显升高(P<0.01),也显著高于对照组(P<0.01),产后2h血浆NO显著高于对照组(P<0.01),但与无宫缩时比较差异无显著性。结论硬膜外阻滞分娩镇痛可降低妊高征患者的血压,其机制可能与血浆中NO含量升高有关。
Obstetrics & Gynecology Hospital, Nantong 226006 Objective To investigate the effects of epidural labor analgesia on plasma nitric oxide in the patients with pregnancy- induced hypertension syndrome. Methods Twenty nine cases with moderate to severe pregnancy induced hypertension syndrome were randomly divided into control and analgesia group. When the cervix dilated to 3～ 4cm in analgesia group, epidural analgesia were begun. The intravenous blood samples were taken before in labor and analgesia? the cervix dilated to 10cm and 2 hours after delivery to determine the plasma concentration of NO. Results The mean artery pressure (MAP) of the cervix dilated to 3～ 4cm was makedly higher than before in labor (P<0.01). The MAP of the cervix dilated to 10cm and 2 hours after delivery in control group were still significantly hither than before in labor (P<0.05) while those in analgesia group were markedly lower than before in labor and the control (P<0.01). The plasma concentration of NO of the cervix dilated to 3～ 4cm were markedly lower than before in labor (P<0.01). In control group, plasma concentration of NO of the cervix dilated to 10cm and 2 hours after delivery were markedly lower than before in labor (P<0.01). In analgesia group, the plasma concentration of NO of the cervix dilated to 10cm were markedly lower than before in labor and the control (P<0.01), that of 2 hours after delivery was significantly higher than the control but no difference to before in labor. Conclusions Epidural labor analgesia on the patients with pregnancy- induced hypertension syndrome can markedly decrease the MAP and the plasma NO may play a role. [
出处
《中国航天医药杂志》
2003年第4期26-28,共3页
Medical Journal of CASE
关键词
硬膜外阻滞
分娩
镇痛
妊娠高血压综合征
血浆一氧化氮
Pregnancy- induced hypertension syndrome Analgesia epidura Obstetrical Analgesia Nitric oxide
